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Laser

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Laser2020-01-06T07:11:33+00:00

Laser

Lasers, of which there are many types, resurface by the discharge of energy from light that is absorbed by molecules in the tissue being treated. For example, the CO2 laser light is absorbed by water molecules. Any tissue with water (skin being the most salient example) will absorb the light from this laser and ultimately transform this energy into heat. Thus a thermal injury will occur-a burn.

The CO2 laser is the most commonly used laser for skin resurfacing. To complicate matters, though, there are different types of CO2 units. Their differences have to do with the amount of energy delivered to a given area over a period of time. The clinical effect (benefit as well as unwanted side effect) is a product of the variables of laser light delivered. The newest is the Unipulse which minimizes much of the morbidity but cosmetically rivals the other CO2 lasers. It is, at least for now, the laser we use at the Center for Plastic Surgery.

The erbium laser is the latest non-CO2 laser for resurfacing. It is mainly intended for very shallow wrinkles. Its effect on deeper skin problems is minimal. This laser allows for relatively rapid healing and has minimal morbidity.

There are other lasers used for treatment of various manifestations of skin aging. Melanotic spots, telangiectasia (small red lesions), and other skin lesions may be preferentially dealt with by a laser. There is not enough space in this manuscript for a thorough discussion of all lasers. What is important to remember is the complexity of treatment options. Skin restoration is very individualized and should be undertaken only when benefits are predictably expected and unwanted side effects are modest or non-existent. This can only be accomplished by a trained and experienced professional.

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Quantum Laser Center

The Quantum Laser Center offers 2 lasers for skin rejuvenation, the Pearl and Unipulse CO2, and one laser for lipolysis by Lipotherme. In properly selected patients, these lasers can assist is generating superb results. We are constantly in the hunt for new technology. At the same time, we understand that lasers are not magic wands. Only patients who will benefit from delivery of laser energy will be treated in our unit. We won’t use them simply because we own them.

The Quantum Laser Center offers 2 lasers for skin rejuvenation, the Pearl and Unipulse CO2, and one laser for lipolysis by Lipotherme. In properly selected patients, these lasers can assist is generating superb results. We are constantly in the hunt for new technology. At the same time, we understand that lasers are not magic wands. Only patients who will benefit from delivery of laser energy will be treated in our unit. We won’t use them simply because we own them.

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Frequently Asked Questions About Lasers

Skin changes in appearance as a consequence of aging regardless of how well it has been cared for. Aging itself is programmed into the genetic information meaning it is unalterable, at least until genetic engineering becomes a practicality.

Smoking, excess sun exposure, and trauma to the skin can accelerate aging. Prophylactic care can certainly minimize the rate of skin aging. Other forms of treatment can make the skin look younger.

Various proteins which provide elasticity to the skin (elastin) deteriorate. Glands that lubricate the skin dry up. Water content decreases as well as a “filler” called ground substance. The collagen content of the skin decreases and the collagen itself becomes deformed. They can be accelerated by sun exposure, smoking, and other forms of trauma. The process moves faster in individuals of fair complexion due to their susceptibility to ultraviolet sun damage. In the end, the rate of visual aging is the sum of normal biologic aging plus alterable factors (eg. sun exposure). True reversal of aging with various treatments is minimal, at best. However, with a combination of prophylactic care and interventional treatment, skin can reclaim some lost years and look more youthful.

Until some genetic breakthrough occurs, the best treatment for aging skin is prophylactic care. Since the biological clock ticks inexorably, one can only avoid the acceleration of aging brought on by external factors. The most significant of these factors is ultraviolet light. Most people receive some exposure by sunlight, but the recent popularity of tanning beds adds another source of skin damaging UV radiation. Those who think that UV light from a tanning bed is not harmful are badly mistaken. All ultraviolet light should be avoided as much as possible. Because sun damage is only partially reversible, and because it accelerates the aging process (which is irreversible), the best way to preserve youthful skin is to avoid sun exposure. Since an exclusively indoor lifestyle is not practical, religious use of sunblock should be undertaken. Sunburns and direct exposure for the purpose of getting a deep tan, which may be temporarily attractive, add to the accumulation of skin injury. Over time these insults to the skin build resulting in aged, leathery, spotty skin. All skin care regimens should include some form of sunscreen or sunblock.
Some skin treatments or medications (Retin-A) may actually make the skin more sensitive to the sun. It is important that patients understand the ramifications of various skin care regimens, particularly when they spend a good deal of time outdoors. In a less specific sense, good nutrition influences overall body health and therefore the health of the skin. Patients should be cautious about various “natural” substances, both applied to the skin and taken by mouth. Although there may be benefits (unsubstantiated as they may be), there may also be negative side effects.
Smoking poisons the skin directly by tars and similar substances deposited directly onto the skin and, indirectly, by its detrimental effects on health in general and circulation in particular. Patients who are heavy smokers have a certain “look” to their skin that comes from poisoning it and suffocating it. “Smoker’s lines” are creases around the mouth that are particularly severe in heavy smokers. Furthermore, patients who are anticipating aesthetic procedures to correct the effects of aging (aggravated, of course, by smoking), subject themselves to greater risk for any operation. For these reasons patients should simply not smoke. There are other environmental factors that may influence the character of the skin. Industrial chemicals may be damaging to workers that are exposed to them. Other medical conditions may also effect the appearance and texture of skin.

There is no cream or treatment that actually reverses aging of the skin. A wrinkle cream or some direct treatment may give skin a more youthful look (and there’s nothing wrong with that!) but will not slow the actual aging process.

Most wrinkle creams are mild irritants that cause swelling in the skin and thus plump out wrinkles. They are commonly combined with an exfoliant to remove the superficial dead cells in the epidermis, the outermost layer of skin.

The retinoins (Renova, Retin-A) increase metabolic activity in the skin (and thus the volume) as well as increase the generation of new cells in the epidermis. They are best used with an exfoliant as the epidermis will build up and begin to visibly peel. Patients respond differently to these topical drugs and should be managed by someone familiar with dosage regulation for best results.

Quinones are bleaching agents for treatment of darkened areas. They are commonly combined with other topical products for best results. Not everyone benefits from quinones.

Various other products are available with questionable benefits. This includes collagen and vitamin products. They are, however, not harmful and often are blended with good moisturizers or sunblocks.

Resurfacing of the skin can be accomplished mechanically, chemically, or thermally. Regardless of technique, the strategy is to create a level of injury to the skin whereby healing of that injury results in improved appearance of the skin. The desired level of treatment can be accomplished mechanically (dermabrasion), chemically (chemical peels), or thermally (laser).

As the skin repairs from this planned injury, changes emerge that make the skin look younger. Discoloration, wrinkles, and even deeper furrows and be eliminated by proper treatment. The specific choice of therapy is dependent upon the condition and type of skin.

Unwanted side effects can accompany resurfacing. This can include increased sensitivity to the sun, unwanted lightening or darkening of the skin, The deeper the treatment the more likely these are to be seen. There must clearly be an understanding of all issues before the patient submits to treatment. Proper management of the patient must involve the input of a knowledgeable professional. Skin condition, lifestyle, previous treatments, anticipated treatments and skin type all influence the choice, if any, of skin resurfacing. Patients must understand that some changes may be permanent and be prepared to make adjustments in their routines to accommodate them.

There are many differnt types of chemical peels. The depth of the peel, and thus the depth of the injury, depends upon the agent used and the manner in which it is employed. Peels can be quite shallow. Shallow peels heal quickly, remain red for short periods of time, have little risk, and seldom cause any color problems. The problem is, they don’t do much. For patients who don’t need much, they’re perfect. For deeper wrinkling, they are a waste of time. Organic acid peels and shallower TCA peels fall into this category.

Intermediate peels have intermediate results, side effects, and risks. Their utility depends upon the severity of the skin problem in question. TCA peels can be intermediate in depth depending on how the solution is applied.

Deep peels, phenol and aggressive TCA peels, do a wonderful job of smoothing even very deep creases and wrinkles in the skin. They do, however, have a greater risk of scarring, commonly lighten the skin, and take much longer to heal. The treating physician must balance these factors to decide if this modality is proper for a patient.

Dermabrasion sands away the surface of the skin mechanically. Most of the time, this is done with a high speed rotary surgical dermabrader specially designed for this task. Depth is determined by the length and repetition of treatment. Most of the time, dermabrasion works better than the other methods of resurfacing when irregularities exist in a small area. For example, if a scar is elevated in an otherwise smooth region, sanding the scar preferentially will lower it relative the skin around it. By way of comparison, chemical resurfacing is best suited for uniform treatment of larger anatomic areas.

Lasers, of which there are many types, resurface by the discharge of energy from light that is absorbed by molecules in the tissue being treated. For example, the CO2 laser light is absorbed by water molecules. Any tissue with water (which includes skin) will absorb the light from this laser and ultimately transform this energy into heat. Thus a planned thermal injury will occur. The healing from the laser treatment creates aesthetically desirable changes. There are different lasers for specific problems.
The Quantum Laser Center offers 2 lasers for skin rejuvenation, the Pearl and Unipulse CO2, and one laser for lipolysis by Lipotherme. In properly selected patients, these lasers can assist is generating superb results. We are constantly in the hunt for new technology. At the same time, we understand that lasers are not magic wands. Only patients who will benefit from delivery of laser energy will be treated in our unit. We won’t use them simply because we own them.
The Pearl laser, like the CO2 laser, has water as its target molecule. Delivered at a different wavelength, the energy is very rapidly taken up by the water in the epidermis converting it to heat. Much of the heat is dissipated into the air (rather than the dermis) so that the depth of laser injury is shallow. The Pearl laser is excellent for treating modest sun damage including dark spots, freckles, delicate wrinkling, and large pore size.

The laser center has had a CO2 laser for many years. It is very effective for treatment of extensive skin damage-deep wrinkles, dark discoloration, and contour problems. For patients who have lesser issues, the CO2 laser is too aggressive a treatment.

The Pearl laser, like the CO2 laser, has water as its target molecule. Delivered at a different wavelength, the energy is very rapidly taken up by the water in the epidermis converting it to heat. Much of the heat is dissipated into the air (rather than the dermis) so that the depth of laser injury is shallow. The Pearl laser is excellent for treating modest sun damage including dark spots, freckles, delicate wrinkling, and large pore size.

First and foremost, individuals that don’t need it. Lasers are powerful tools for treating specific problems. They are not prophylaxis against skin aging.
Darker skin types may be poor candidates for laser therapy, especially deep treatments which the CO2 laser delivers. The Pearl can be used in a broader range of skin types, but is done with great caution in very dark skin. Usually a test spot is done in these patients prior to formal treatment.
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VINCENT N. ZUBOWICZ MD VNZ Plastic Surgery Emory University Hospital & Health Clinic 5 Star Rated Facelift and Breast Aug Makeover

Call our office at the Emory Aesthetic center at:

(404)778-6879

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